ABSTRACT
En Paraguay, desde 2008 se procesa la reforma de la Atención Primaria de Salud, buscando reducir inequidades. Con el objetivo de conocer el rol de la Atención Primaria de Salud en la reordenación del sistema de salud, se utilizó la herramienta Primary Care Assessment Tool para estudiar los Equipos de Salud Familiar en Asunción. Fueron entrevistados 360 usuarios y 36 profesionales. Los resultados cubren las dimensiones acceso, puerta de entrada, vínculo, integralidad, coordinación, enfoque familiar, orientación a la comunidad, y formación profesional. Se observa que usuarios y profesionales tienen percepciones diferentes, pero convergen que el acceso es un punto débil y la formación profesional uno fuerte. Se concluye que hay una importante inversión en la Atención Primaria de Salud, pero la población aún no se está apropiando de toda su potencialidad.
In Paraguay, since 2008 a Primary Health Care reform is taking place, aiming at reducing inequities. With the objective of understanding the role of Primary Health Care in the reorganization of the health system, the Primary Care Assessment Tool was used to study the Family Health Teams in Asunción. We interviewed 360 users and 36 health professionals. The results cover the dimensions of access, gateway, longitudinality, portfolio, coordination, family focus, community orientation, and professional training. It was observed that users and professionals have different perceptions, but agree that access is a weakness and training a strength. It is concluded that there is an important investment in Primary Health Care, however the population is still adapting their full potential.
ABSTRACT
Avaliou-se a eficácia de um larvicida, temefós, para controlar Ae. aegypti em um cemitério de Buenos Aires, Argentina. Os criadouros reduziram de 18,4 por cento no primeiro período de estudo (nov de 1998 a maio de 1999, sem temefós) para 2,2 por cento no segundo (nov de 1999 a maio de 2000, duas aplicações), e para 0,05 por cento no terceiro (nov de 2000 a maio de 2001, cinco aplicações). As. ovitrampas com ovos diminuíram de 17 por cento no primeiro período para 5,8 por cento no segundo e para 2,9 por cento no terceiro. Os resultados sugerem que, em Buenos Aires, as populações de Ae. aegypti são altamente susceptíveis ao temefós. É recomendável seu uso para prevenir eventuais epidemias e não para o controle rotineiro.
Subject(s)
Aedes , Vector Control of Diseases , Temefos , Mosquito Control , Insect Vectors , Insecticide ResistanceABSTRACT
In Buenos Aires, the most crowded city of Argentina, there is a potential risk of dengue virus transmission by the mosquito Aedes aegypti during late summer. The temporal patterns of oviposition activity and abundance of breeding sites of this vector were studied in two cemeteries of the city. Between September 1998 and August 1999, we examined 142 ovitraps weekly and a total of 18,010 water-filled containers. Both study areas showed remarkable differences in the percentages of positive ovitraps (19 percent vs 8 percent) and breeding sites (18 percent vs 1 percent), but similar temporal abundance patterns. The percentage of breeding sites was higher in summer and autumn than in spring and winter, and the percentage of positive ovitraps was higher in summer than in the other three seasons. Immatures were recorded from the first week of October to the second week of July, and oviposition activity from the third week of October until the end of April. In both cemeteries and with both methodologies the highest infestation levels were registered in March (ovitraps: 41.8 percent and 20.6 percent, breeding sites: 39.2 percent and 3.4 percent). These highest abundances took place after several months with mean temperatures above 20§C and accumulated rainfalls above 150 mm. A sharp decline in oviposition activity was observed when monthly mean temperature decreased to 16.5§C, and no eggs were found below 14.8§C. Seasonal fluctuation of Ae. aegypti abundances in mid-latitudes like Buenos Aires would allow reduction of the egg mosquito population through the elimination of containers during the coldest months, which are free of adults.
Subject(s)
Animals , Male , Female , Aedes , Insect Vectors , Seasons , Disease Reservoirs , Mortuary Practice , Oviposition , Population DensityABSTRACT
Cemeteries with many water-filled containers, flowers, sources of human blood, and shade are favorable urban habitats for the proliferation of Aedes aegypti, a vector of yellow fever and dengue. A total of 22,956 containers was examined in the five cemeteries of the city of Buenos Aires, Argentina. The vector was found in four cemeteries that showed an average infestation level of 5.5 percent (617 positive out of 11,196 water-filled containers). The four cemeteries positive for Ae. aegypti showed significantly different (p<0.01) infestation levels. Vegetation cover and percentage of infestation were significantly correlated (p<0.01), but neither cemetery area nor number of available containers were significantly related to the proportion of positive vases. Our results suggest that the cemeteries of Buenos Aires represent a gradient of habitat favorableness for this vector species, some of which may act as foci for its proliferation and dispersal